Tag: nevin manimala

J Contin Educ Nurs. 2022 Sep;53(9):417-423. doi: 10.3928/00220124-20220805-08. Epub 2022 Sep 1.

ABSTRACT

Background Antibiotic resistance is a leading global public health threat. Nurses are well positioned to optimize antibiotic use via targeted antibiotic stewardship (AS) nursing practices. However, standardized AS education for nurses is lacking. The objective of this study was to evaluate the effect of an online AS for nurses continuing education program on nurses’ antibiotic resistance, antibiotic, and AS knowledge and their intent to integrate AS into their clinical practice. Method A quasi-experiential pretest-posttest design was used with a convenience sample of nurses at a U.S. academic medical center. Focus groups were conducted with those completing the program. Results Forty-seven of 100 eligible nurses completed the program and the pre- and posttest surveys. Participation resulted in statistically significant increases (p < .05) in antibiotic resistance, antibiotic, and AS knowledge, confidence, and perceptions related to the role of nursing in AS. Focus group participants had multiple recommendations for ways to integrate AS in daily nursing practice. Conclusion Completing a comprehensive AS nursing continuing education program could prove instrumental to motivating nurses to adopt AS nursing practices. [J Contin Educ Nurs. 2022;53(9):417-423.].

PMID:36041206 | DOI:10.3928/00220124-20220805-08

Am J Clin Nutr. 2022 Aug 30:nqac238. doi: 10.1093/ajcn/nqac238. Online ahead of print.

ABSTRACT

BACKGROUND: High energy intake from non-nutrient dense sources correlates with poorer diet quality.

OBJECTIVES: To, 1) estimate total energy intake, and energy from solid fats and added sugars, and combined (SOFAS), and identify their top food category sources for ages 2-18 years in 2015-2018, and 2) describe trends over time in 2009-2018.

DESIGN: Data were from the National Health and Nutrition Examination Survey. Pairwise differences were examined using univariate t statistics (2015-2018, n=5,038), and trends by age, and over time (2009-2018, n=14,038) examined using orthogonal polynomials.

RESULTS: In 2015-2018, SOFAS contributed (mean [SE], 30.0% [0.3%]) of total energy. Solid fats 16.1% [0.2%] and added sugars 13.8% [0.2%] each contributed >10%. The contribution of added sugars increased with age from 11.1% (2-3 years) to 14.4% (14-18 years), and was higher for all other race/Hispanic origins than Non-Hispanic Asians. Top five sources of energy were sweet bakery products, savory snacks, pizza, other mixed dishes, and unflavored milk, and for SOFAS also included soft drinks, other desserts, candy and snack bars. Total energy did not change between 2009-2018, but energy from SOFAS, and servings of solid fats, and added sugars declined. The contribution of unflavored milk to total energy declined for all ages and most race/Hispanic origins. Fruit drinks (all ages) and soft drinks (9-18 years) remained among top added sugars sources despite declines. The contribution of sweet bakery products to energy from SOFAS increased for most ages, and candy and snack bars to energy from added sugars.

CONCLUSIONS: In 2015-2018, SOFAS contributed over 30% of total energy for ages 2-18 years, which doubled the Dietary Guidelines for Americans’ recommended limit of 15%. Top five sources of total energy were similar to those of solid fats, and those of SOFAs similar to those of added sugars. These results may inform public health efforts for improving diet quality.

PMID:36041175 | DOI:10.1093/ajcn/nqac238

J Craniofac Surg. 2022 Jul-Aug 01;33(5):e507-e509. doi: 10.1097/SCS.0000000000008482. Epub 2022 Feb 2.

ABSTRACT

PURPOSE: The frequency and types of salivary gland tumors show significant geographical variations. The most common are primary epithelial tumors, with pleomorphic adenoma and mucoepidermoid carcinoma being the most frequent. This study aims to analyze the clinicopathological data of patients with major and minor salivary gland (MiSG) tumors.

METHODS: The retrospective study included all patients with major and MiSG tumors diagnosed and treated between January 2000 and January 2019. Files of 907 patients were reviewed and investigated for clinicopathologic features of major and MiSG tumors in Serbia.

RESULTS: The majority of tumors were of epithelial origin. Pleomorphic adenoma was the predominant type of tumor, with 35.1% among all tumors on all sites. Adenoid cystic carcinoma and mucoepider-moid carcinoma (with 7.1% and 2.7%, respectively) were the most common malignant ones. The most common localization was the parotid gland. Minor salivary gland tumors comprised 16.43% of all salivary gland tumors in our series, the most common localization being the oral cavity. The results of our study are mostly consistent with the results of other previously published studies.

CONCLUSIONS: The most important finding, worth emphasizing, is that the most common malignant major and MiSG tumor in our population is adenoid cystic carcinoma, rather than mucoepidermoid carcinoma, in all investigated localizations. In addition, the nasal cavity is the most common localization among malignant MiSG tumors.

PMID:36041131 | DOI:10.1097/SCS.0000000000008482

J Craniofac Surg. 2022 Jul-Aug 01;33(5):1458-1461. doi: 10.1097/SCS.0000000000008335. Epub 2021 Oct 27.

ABSTRACT

INTRODUCTION: Prominent ear is 1 of the most common congenital deformities of the ear. Incidence is reported as approximately 5%. This deformity can classically be the result of antihelix insufficiency, overprojection of concha or combination of both. Less frequently, folded or overprojectile ear lobule can aggravate the deformity. Surgical techniques can be aimed at concha, antihelix formation, lobule positioning. In our study, postoperative results for the combination of suture otoplasty and perichondrioadipodermal flap techniques in prominent ear surgery is discussed in light of the recent literature.

METHODS: Forty-nine patients that were operated for prominent ear deformity in our clinic between 2010 and 2015 were evaluated. Anatomic structures that cause the anomaly was analyzed by photographing concha-scaphoid angle, antithetical fold absence or presence, position of the ear lobule, conchal depth, size of the auricula, and positioning Frankfort Plane parallel to the ground. The patients were photographed preoperatively, at postoperative first week and postoperative sixth month, respectively. Comparison of age, surgical technique, surgical complications, necessity for revision surgery, additional procedures, follow up time, preoperative, and postoperative helix-mastoid bone distance were evaluated.

RESULTS: Forty-nine patients have been evaluated. Thirty-one of these patients were female, whereas 18 were male. Age of these patients ranged between 6 and 37. Operations were performed in 47 right side ears, and 44 left side ears (97% bilateral and 7% unilateral otoplasty). Preoperative helix-mastoid bone distance ranged between 21 and 33 mm (mean 26.77), whereas postoperative helix-mastoid bone distance was measured between 12 and 22 mm (mean 16.26). Compared to the preoperative values, helix-mastoid distance difference was statistically significant (P < 0.05).

CONCLUSIONS: Asymmetry and recurrence are the most common late complications of prominent ear surgeries. Perichondrioadipodermal flap can be safely added to the combined surgical techniques protecting the cartilage support, therefore, reducing complication rates, with satisfying results.

PMID:36041141 | DOI:10.1097/SCS.0000000000008335

J Craniofac Surg. 2022 Jul-Aug 01;33(5):1599-1602. doi: 10.1097/SCS.0000000000008229. Epub 2021 Oct 12.

ABSTRACT

OBJECTIVE: Due to being the weakest sutural junction of the crania and relations with intracranial anatomical structures, the accurate location of the pterion is important for surgical approaches such as in pterional craniotomy. The aim of the study was to develop regression equations to estimate the person-specific accurate location of the pterion based on the cranial morphometry.

MATERIALS AND METHODS: The study was conducted on 22 pterions located 11 dry skulls belonging to Anatomy Department of the Harran University, Medical Faculty. Twelve parameters related to pterion and 23 parameters related to the skull was measured using ImageJ software. SPSS 20.0 was performed for statistical analyses such as descriptive and comparative statistics and developing regression equations.

RESULTS: Statistically significant difference wasn’t observed between right and left sides. The 12 equations, such as P8:distance between pterion and the tip of the mastoid process= 63,780 + (1,366 × K6) – (2,786 × K7) + (1,342 × K11) – (1,029 × K13) + (2,102 × K14) – (1,710 × K15) – (0,517 × 22) Adjusted R2= 0.995 and Standard Errors = 1.221 were developed to estimate the accurate location of the pterion based on the cranial morphometry.

CONCLUSIONS: In the previous studies, the mean distances of the pterion to certain landmarks on the crania were given. The authors developed formulas in order to estimate the accurate person-specific location of the pterion. The authors are convinced that the equations they have developed will help neurosurgeons in terms of surgical approaches.

PMID:36041125 | DOI:10.1097/SCS.0000000000008229

J Craniofac Surg. 2022 Jun 1;33(4):1182-1184. doi: 10.1097/SCS.0000000000008468.

ABSTRACT

The aim of this study was to understand the impact of the COVID-19 pandemic on the epidemiology of maxillofacial trauma in a regional trauma center in L’Aquila, Abruzzo, Italy, during the first wave of the pandemic and comparted it to an equivalent period from 2015 to 2018. The authorshave retrospectively analyzed personal data, site of trauma, etiology, and mechanism of injury. Statistical analysis has been carried out utilizing IBM SPSS Statistics software (IBM Corp., Armonk, NY) and significance was accepted for P values of <0.05. From January 2015 to December 2020, a total of 296 were analyzed. In Pre-COVID era, 195 patients were evaluated, 130 males (66.6%) and 65 females (33.4%). Zygomatic-malar complex fractures were the most common site of trauma in both genders (53%), followed by mandibular fractures (23%) and orbital ones (15%). The highest incidences of injuries were recorded between 15 and 34 years (21%) with the most common etiology attributed to road accidents traumas (49%). In COVID19 era, the authors recorded 101 traumas, 58 males (57.4%), 43 females (42.6%). Zygomatic-malar complex fractures were confirmed as the most common ones in both genders (41%). The most common etiology was related to casual domestic accident and assaults (37% and 30%, respectively). There was no statistically significant difference in terms of incidence in the comparison of Pre-COVID19 and COVID19 periods (P > 0.05) as opposed to the etiology in which the road traffic accidents decreased in favor of domestic accidents and interpersonal assaults (P < 0.05). Our scientific study represents the first epidemiologic study related to the impact of COVID-19 on maxillo-facial trauma in the Province of L’Aquila, Abruzzo, Italy. A decrease in the number of Maxillofacial injuries related to road traffic accidents can be demonstrated as the benefit of lockdown, however, a significant increase in the number of physical assaults shows how isolation and restrictions have had a highly negative psychological impact on society.

PMID:36041111 | DOI:10.1097/SCS.0000000000008468

J Craniofac Surg. 2022 Jun 1;33(4):1166-1169. doi: 10.1097/SCS.0000000000008444. Epub 2021 Dec 16.

ABSTRACT

BACKGROUND: Maxillofacial fractures require stable fixation for uneventful bony healing and optimal remodeling. Conventional titanium plates considered the gold standard of rigid internal fixation for many years, however due to the inherent drawbacks associated with metal devices biodegradable plates have been developed.

AIM OF THE STUDY: To evaluate the efficacy of biodegradable plates as a treatment modality of rigid internal fixation for facial fractures and to assess the perioperative complications experienced with their utilization.

PATIENTS AND METHODS: This prospective clinical study included 10 Iraqi patients, met the eligibility criteria and subjected to open reduction and internal fixation with biodegradable plates system. The data were analyzed according to the age, gender, etiology of the fracture, fracture site, surgical approach, plate application time, fracture reduction, screw holes ossification, and patient’s satisfaction. The patients were radiographically followed up with either computed tomography or CBCT at 3, 24, and 48 weeks with regular follow up intervals. The statistical analysis was performed using percentages, the mean ± standard deviation, Shapiro-Wilk test and Mann-Whitney U test.

RESULTS: The age of patients ranged from 9 to 65 years with an average of 26.1 years and a standard deviation of ± 12.9. Regarding gender, males showed a higher percentage than female (80% versus 20%), respectively. There was a significant difference between the mean time of plate application in midface and mandible (53 versus 32.9 minutes), respectively. All cases end up with complete screw holes ossification.

CONCLUSIONS: This study demonstrated that biodegradable plating system was a sensitive procedure and greatly depended upon surgeon’s experience and improvement of the learning curve.

PMID:36041110 | DOI:10.1097/SCS.0000000000008444

J Craniofac Surg. 2022 Jun 1;33(4):1108-1110. doi: 10.1097/SCS.0000000000008076. Epub 2021 Aug 10.

ABSTRACT

One of the methods applied to ensure the long-term continuity of the desired result in rhinoplasty is to detect it by placing columellar strut between the medial crus. Columellar strut helps to increase tip support and projection. However, the placement of the strut between the medial crus can disrupt the divergence angle and prevent the tip rotation to be at the desired level due to the interaction of the septum with the caudal. in this study, the data obtained by fixing the columellar strut to the lateral faces of the medial crus are shared. in 51 primary rhinoplasty patients who underwent open rhinoplasty, the medial crus was dissected and released. The distance between the footplates and the new domes was measured and the length of the columellar struts was determined. Grafts obtained from cartilage septum were shaped. After symmetry was achieved between the medial crus, the prepared grafts were fixed to the lateral face of the medial crus. Preoperative and postoperative 12th month images were transferred to computer- aided program and nasolabial angles were measured. The obtained data were transferred to SPSS 22.0 (IBM Corp., Armonk, New York, USA) program and statistical comparisons were made. Fifty one patients were included in the study. Thirty eight of the patients were female and 13 were male. The mean age of the patients included in the study was 29.2 years. The mean preoperative nasolabial angle was 90.2 degrees postoperatively, and the average nasolabial angle was 104.2 degrees at 6 months. A statistically significant difference was found between preoperative and postoperative measurements (P < 0.05). Lateral columellar strut is an effective and reliable and novel method for increasing the stability of medial crus, maintaining tip support in postoperative period and increasing tip rotation.

PMID:36041106 | DOI:10.1097/SCS.0000000000008076

J Craniofac Surg. 2022 Jun 1;33(4):1147-1149. doi: 10.1097/SCS.0000000000008314. Epub 2021 Oct 27.

ABSTRACT

PURPOSE: To determine factors influencing postoperative enophthalmos after reconstruction of orbital wall fracture.

METHOD: Data of consecutive patients who were diagnosed with unilateral medial or inferior orbital wall fracture from March 2013 to February 2020 were retrospectively reviewed. Forty-three patients were included in this study (24 with medial orbital wall fracture and 19 with inferior orbital wall fracture). Their medical records including Hertel exophthalmometry, preoperative computed tomography (CT) scan, and postoperative CT scan were reviewed. The degree of enophthalmos developed was calculated by measuring exophthalmos before surgery and at 6 months after surgery. Patients were classified into 2 groups depending on whether reduction was good after surgery or not. Data (eg, age, gender, onset, fracture size, and so on) were then compared between these 2 groups.

RESULTS: A total of 43 patients were included in the study. Their mean age was 40.1 years. There were 34 (79.1%) males. The mean onset from trauma to surgery was 8.1 days. Insufficient soft tissue reduction was found in 9 patients through postoperative CT scan. Preoperative mean enophthalmos was – 1.70 mm. Postoperative mean enophthalmos was -0.45 mm after 6 months. The mean fracture size was 213.74 mm2. There was no statistically significant difference in enophthalmos at 6 months after surgery regardless whether the reduction was good or not. Enophthalmos at 6 months after surgery was associated with preoperative fracture size and onset.

CONCLUSIONS: Postoperative enophthalmos development might be associated with preoperative fracture size and onset. Delayed operation in case of large orbital wall fracture might lead to undesired result. Thus, surgeons should keep that in mind.

PMID:36041108 | DOI:10.1097/SCS.0000000000008314

J Craniofac Surg. 2022 Jun 1;33(4):1057-1062. doi: 10.1097/SCS.0000000000008440. Epub 2021 Dec 16.

ABSTRACT

The purpose of this prospective multicenter study was to analyze the epidemiology, patterns, and management of maxillofacial fractures due to road traffic accidents (RTAs) worldwide.Between Monday September 30, 2019 and Sunday October 4, 2020,1066 patients with RTAs related fractures were admitted to 14 maxillofacial surgery departments. The following data were analyzed: age, gender, mechanism of injury, alcohol or drug abuse at the time of trauma, maxillofacial fracture site, facial injury severity scale (FISS) score, associated injuries, day and month of trauma, time of treatment, type of treatment and length of hospital stay. Data were analyzed using bivaried and multivaried statistical analysis.Eight hundred seventy patients were male, and 196 were female. The most common mechanism of injury was motorcycle accidents (48%). More than half of the patients had fractures of the middle third of the maxillofacial skeleton. In total, 59% of the study sample underwent open reduction internal fixation. The median facial injury severity scale (3 points) and the medial hospital stay (3 days) were significantly lower in patients with seatbelts and helmet (P < 0.001).This first prospective, multicenter epidemiological study shows that motorcycle accidents are the leading cause of RTAs related fractures, mostly in young males. Particularly in Australia and Europe, the incidence of RTAs was significantly lower. Moreover, this study found that the severity of maxillofacial lesions was significantly higher in patients without safety devices, with consequent longer hospital stay demonstrating the efficacy of road safety policies in preventing maxillofacial injury.

PMID:36041104 | DOI:10.1097/SCS.0000000000008440